Surface roughness of etched composite resin in light of composite repair

Scoping review: Effect of surface treatments on bond strength of resin composite repair

OBJECTIVE

to evaluate the existing evidence on surface treatment techniques employed in resin composite repair and their effect on the repair short- and long-term bond strength.

DATA AND SOURCE

This scoping review was performed under the PRISMA-ScR guidelines for scoping reviews and registered on the Open Science Framework platform.

STUDY SELECTION

A systematic search was conducted in PubMed, Embase, and Scopus and grey literature up to September 2022 without language or date restriction. In vitro studies comparing mechanical surface and/or chemical treatments on repair bond strength of resin composite were included. Studies evaluating experimental adhesive systems or resin composites were excluded. Selection of studies and data extraction were performed. Data from selected studies was qualitatively analyzed.

RESULTS

A total of 76 studies were included in the qualitative analysis. Among the mechanical treatments, alumina blasting was the most frequently used, followed by silica coating and diamond bur. As for chemical treatments, dentin bonding systems were the most frequently evaluated, followed by universal adhesive systems and silane/ceramic primer. The combination of mechanical and chemical pre-treatments increased the repair bond strength of resin composite in both short- and long-term simulated aging scenarios. The evidence obtained from the included studies was classified as moderate quality, mainly due to the medium risk of bias observed across most of the studies.

CONCLUSION

The techniques used to treat the surface of resin composites for repair are diverse. Incorporating a combination of mechanical and chemical pre-treatments resulted in superior repair bond strength of resin composite materials under both short- and long-term simulated aging conditions.

CLINICAL SIGNIFICANCE

The analysis of evidence revealed significant variability among protocols for repairing resin composites. Utilizing both mechanical and chemical pre-treatment methods is important for enhancing the bond strength of resin composites during both short- and long-term simulated aging situations.

Comparative Evaluation of the Repair Bond Strength of Dental Resin Composite after Sodium Bicarbonate or Aluminum Oxide Air-Abrasion

The dental prophylactic cleaning of a damaged resin-based composite (RBC) restoration with sodium bicarbonate can change the surface characteristics and influence the repair bond strength. The purpose of this study was to compare the effect of sodium bicarbonate (SB) and aluminum oxide (AO) surface treatments on the microtensile bond strength (µTBS) of repaired, aged RBC. Bar specimens were prepared from microhybrid RBC and aged in deionized water for 8 weeks. Different surface treatments (AO air-abrasion; SB air-polishing), as well as cleaning (phosphoric acid, PA; ethylene-diamine-tetraacetic-acid, EDTA) and adhesive applications (single bottle etch-and-rinse, ER; universal adhesive, UA), were used prior to the application of the repair RBC. Not aged and aged but not surface treated RBCs were used as positive and negative controls, respectively. The repaired blocks were cut into sticks using a precision grinding machine. The specimens were tested for tensile fracture and the µTBS values were calculated. Surface characteristics were assessed using scanning electron microscopy. AO-PA-UA (62.6 MPa) showed a 20% increase in µTBS compared to the NC (50.2 MPa), which proved to be the most significant. This was followed by SB-EDTA-UA (58.9 MPa) with an increase of 15%. In addition to AO-PA-UA, SB-EDTA-UA could also be a viable alternative in the RBC repair protocol.

Chemical Surface Modification Methods of Resin Composite Repaired with Resin-Modified Glass-Ionomer Cement

OBJECTIVE

 This study examined the chemical surface modification methods of resin composite repaired with resin-modified glass-ionomer cement (RMGIC).

MATERIALS AND METHODS

 Ninety aged resin composite rods were produced and sorted into 9 groups of 10 specimens and surface modified with silane agent and/or bonding agent as follows: group 1, no surface modified; group 2, etch + single bond 2 (SB2); group 3, SB2; group 4, etch + RelyX ceramic primer (RXP) + SB2; group 5, RXP + SB2; group 6, etch + single bond universal (SU); group 7, SU; group 8, etch + RXP + SU; and group 9, RXP + SU. A clear silicone mold was placed on the top of specimen center, and then filled with RMGIC. The specimens' shear bond strengths (SBSs) were examined in mechanical testing equipment. To determine failure types, the fractured specimen surfaces were inspected using a stereomicroscope.

STATISTICAL ANALYSIS

 The data collected were analyzed using one-way analysis of variance, and significance level was operated using Tukey's test (p < 0.05).

RESULTS

 Group 8 had the greatest SBS, but it was statistically indistinguishable from groups 4, 5, and 9. The most frequent fracture mode was adhesive failure. High SBS was commonly associated with mixed failure.

CONCLUSION

 The use of bonding agents enhances the resin composite's wettability and allows it to bond to RMGIC. Moreover, the use of the silane coupling agent before applying bonding agent showed significantly higher bonding ability of resin composite and RMGIC interface.

In Vitro Comparison of Surface Roughness, Flexural, and Microtensile Strength of Various Glass-Ionomer-Based Materials and a New Alkasite Restorative Material

This study aims to evaluate the physical properties of Cention N and various glass-ionomer-based materials in vitro. The groups were obtained as follows: Group 1 (LC-Cent): light-cured Cention N; Group 2 (SC-Cent): self-cured Cention N; Group 3 (COMP): composite (3M Universal Restorative 200); Group 4 (DYRA): compomer (Dyract XP); Group 5 (LINER): Glass Liner; Group 6 (FUJI): FujiII LC Capsule; and Group 7 (NOVA): Nova Glass LC. For the microtensile bond strength (μTBS) test, 21 extracted human molar teeth were used. The enamel of the teeth was removed, and flat dentin surfaces were obtained. Materials were applied up to 3 mm, and sticks were obtained from the teeth. Additionally, specimens were prepared, and their flexural strength and surface roughness (Ra) were evaluated. Herein, data were recorded using SPSS 22.0, and the flexural strength, μTBS, and Ra were statistically analyzed. According to the surface roughness tests, the highest Ra values were observed in Group 6 (FUJI) (0.33 ± 0.1), whereas the lowest Ra values were observed in Group 2 (SC-Cent) (0.17 ± 0.04) (p < 0.05). The flexural strengths of the materials were compared, and the highest value was obtained in Group 2 (SC-Cent) (86.32 ± 15.37), whereas the lowest value was obtained in Group 5 (LINER) (41.75 ± 10.05) (p < 0.05). When the μTBS of materials to teeth was evaluated, the highest μTBS was observed in Group 3 (COMP) (16.50 ± 7.73) and Group 4 (DYRA) (16.36 ± 4.64), whereas the lowest μTBS was found in Group 7 (NOVA) (9.88 ± 1.87) (p < 0.05). According to the μTBS results of materials-to-materials bonding, both Group 2 (SC-Cent) and Group 1 (LC-Cent) made the best bonding with Group 3 (COMP) (p < 0.05). It can be concluded that self-cured Cention N had the highest flexural strength and lowest surface roughness of the seven materials tested. Although the bond strength was statistically lower than conventional composites and compomers, it was similar to resin-modified glass ionomer cements. Additionally, the best material-to-material bonding was found between self-cured Cention N and conventional composites.

Study on βTCP/P(3HB) Scaffolds-Physicochemical Properties and Biological Performance in Low Oxygen Concentration

The search for new materials for bone regenerative purposes is still ongoing. Therefore, we present a series of newly constructed composites based on β tricalcium phosphate (βTCP) and poly(3-hydroxybutyrate) bacteria-derived biopolymer (P(3HB)) in the form of 3D scaffolds with different pore sizes. To improve the polymer attachment to the βTCP surface, the etching of ceramic sinters, using citric acid, was applied. As expected, pre-treatment led to the increase in surface roughness and the creation of micropores facilitating polymer adhesion. In this way, the durability and compressive strength of the ceramic-polymer scaffolds were enhanced. It was confirmed that P(3HB) degrades to 3-hydroxybutyric acid, which broadens applications of developed materials in bone tissue engineering as this compound can potentially nourish surrounding tissues and reduce osteoporosis. Moreover, to the best of our knowledge, it is one of the first studies where the impact of βTCP/P(3HB) scaffolds on mesenchymal stem cells (MSCs), cultured in lowered (5%) oxygen concentration, was assessed. It was decided to use a 5% oxygen concentration in the culture to mimic the conditions that would be found in damaged bone in a living organism during regeneration. Scaffolds enabled cell migration and sufficient flow of the culture medium, ensuring high cell viability. Furthermore, in composites with etched βTCP, the MSCs adhesion was facilitated by hydrophilic ceramic protrusions which reduced hydrophobicity. The developed materials are potential candidates for bone tissue regeneration. Nevertheless, to confirm this hypothesis, in vivo studies should be performed.

Repair of Bulk-Fill and Nanohybrid Resin Composites: Effect of Surface Conditioning, Adhesive Promoters, and Long-Term Aging

The aim of the study was to investigate the effect of different repair procedures on the repair bond strength of bulk-fill and nanohybrid resin composites after different aging periods. The resin composite blocks (8 × 8 × 4 mm3) were prepared from a bulk-fill (reliaFIL Bulk) and a nanohybrid (reliaFIL LC) resin composite and grouped according to aging duration (6 months, 1 year, and 2 years). Following aging, the blocks were assigned to different surface treatments; air-abrasion with aluminum oxide powder, roughening with a diamond bur, and no treatment. After cleansing with phosphoric acid, a silane layer (Porcelain Primer) was applied on the surface of half of the specimens in each group. The specimens were subdivided into two groups (n = 5): Scotchbond Universal (3M Oral Care) and All-Bond Universal (Bisco). The blocks were repaired with the nanohybrid composite (8 × 8 × 8 mm 3). The repaired specimens were stored in distilled water (37 °C/24 h) and segmented into beams. Half of the beams were immediately subjected to microtensile μTBS testing (1 mm/min), while the other half was stored in distilled water (37 °C) for 6 months before testing. Failure modes were analyzed using stereomicroscope and SEM. Statistical analyses were performed with ANOVA and least significant difference tests (LSD) tests (p = 0.05). The extension of aging periods (6 months, 1 year, and 2 years) reduced the repair bond strength in some groups for both resin composites (p < 0.05). The air-abrasion and bur roughening improved the repair bond strength (p < 0.05). The silane application did not influence the repair bond strength and durability (p > 0.05). There was no difference among the universal adhesives in the same surface treatment groups (p > 0.05). The mechanical roughening treatments are necessary for the repair of resin composite. The universal adhesives might be used for the repair of resin composites regardless of silane content without prior silane application.

Effects of different universal adhesives and surface treatments on repair bond strength between resin composites

OBJECTIVE

This study aimed to evaluate the effects of different universal adhesives and surface treatments on the repair bond strength between resin composites.

MATERIALS AND METHODS

A total of 220 composite samples were divided into three groups according to the adhesive resin to be applied: 1) Scotchbond Universal, 2) G-Premio Bond, and 3) Peak Universal Bond. They were then divided into seven subgroups according to surface treatments (n = 10): A) air abrasion, B) air abrasion+silane, C) hydrofluoric acid, D) hydrofluoric acid+silane, E) air abrasion+hydrofluoric acid+silane, F) silane, and G) no surface treatment (negative control). After surface treatment, a repair composite was applied. Samples aged in the thermocycle were subjected to micro-tensile bond strength testing. Cohesive strength values of 10 non-aged composite blocks were used as a positive control. Kruskal-Wallis and one-way ANOVA tests were used for statistical evaluation. Fractured surfaces were evaluated using a scanning electron microscope.

RESULTS

In Scotchbond Universal and G-Premio Bond, the mean micro-tensile bond strength value of the no surface treatment subgroup was significantly lower than that of the positive control. All subgroups of Peak Universal Bond showed similar values to the positive control.

CONCLUSION

While Scotchbond Universal and G-Premio Bond required mechanical roughening before adhesive application, Peak Universal Bond did not require any surface treatment.

CLINICAL SIGNIFICANCE

Different universal adhesives may show different repair bonding strengths with different surface treatments. Since achieving a standard in this regard can be associated with many independent factors, clinicians should determine how to apply the adhesive they use most effectively with the most appropriate surface treatment based on their own clinical experience.

Repairability of aged dimethacrylate-free ORMOCER-based dental composite resins with different surface roughening methods and intermediate materials

STATEMENT OF PROBLEM

The repair of damaged composite resin restorations has been recommended as a conservative treatment option. However, a reliable protocol for repairing ORMOCER-based restorations is lacking.

PURPOSE

The purpose of this in vitro study was to investigate the effect of different surface roughening methods, repair composite resins, and intermediate materials on the repair bond strength of a dimethacrylate-free ORMOCER-based composite resin.

MATERIAL AND METHODS

Cylindrical composite resin specimens (Admira Fusion) were roughened by using hydrofluoric acid (HF) or a diamond rotary instrument. In both groups, 4 types of intermediate materials were used (Monobond-S, Clearfil SE bond [second bottle], Clearfil Universal bond, GC Composite Primer), and then half of the specimens were repaired with a similar composite resin, and the other half with dimethacrylate composite resin (Clearfil-APX). The specimens (n=20) were then subjected to repair bond strength and failure mode evaluation. The data were analyzed by using the Weibull test, 3-way and 1-way ANOVA, and the Tukey honestly significant difference (HSD) test (α=.05).

RESULTS

All variables, including the surface roughening method, intermediate material, and repair composite resin, had a significant effect on repair bond strength (P<.001). The lowest repair bond strength values were obtained in the group roughened with HF, prepared with Monobond-S, and repaired with Admira Fusion, and the highest values were obtained in the group roughened with a rotary instrument, prepared with GC Composite Primer, and repaired with Clearfil APX (P<.05). All experimental groups had a lower bond strength than the cohesive and control groups (P<.05). In all experimental groups, the predominant failure modes were adhesive and mixed.

CONCLUSIONS

The use of a diamond rotary instrument was a more reliable method of creating roughness, and different intermediate materials based on the clinical situation can be used to repair dimethacrylate-free ORMOCER-based composite resin with similar or different composite resins. However, in general, the highest repair bond strengths were achieved with Clearfil APX-repaired specimens.

The Effect of Different Surface Roughening Systems on the Micro-Shear Bond Strength of Aged Resin Composites

Background

There are controversies regarding the most effective surface treatment method to be applied for the effective repair of resin composites.

Aims

This study aimed to compare the effects of surface roughening processes on repair bond strength of different types of aged composites. Water aging was applied to 60 nanohybrid and 60 micro-hybrid resin composite samples for 1 year. Samples were randomly divided into five groups and four types of roughening processes. Bur, OPTIDISC, SUPERSNAP, and BISCO were applied to the water-aged resin composite samples. Micro-shear test method was used to measure the repair bond strength.

Materials and Methods

Data were analyzed with IBM SPSS V23. Compliance with normal distribution was examined by Kolmogorov-Smirnov test. Two-way analysis of variance (ANOVA) and Tukey HSD test for multiple comparisons were used.

Results

The main effect of the type of resin composites and surface roughening methods were found to be significantly different. The MPa values of surface roughening groups were similar while the lowest mean value was obtained for the untreated group of the nanohybrid resin composite (P < 0.001). The bond strength for both resin composites was generally considered within acceptable limits except for no treatment group of nanohybrid resin composite.

Conclusions

This study showed that surface roughening method is mandatory for effective bond strength and the type of fillers in resin composite affects the micro-shear bond strength.

Effect of adhesive application method on repair bond strength of composite

Objectives

This study aimed to evaluate the effect of the application method of universal adhesives on the shear bond strength (SBS) of repaired composites, applied with different thicknesses.

Materials and Methods

The 84 specimens (Filtek Z350 XT) were prepared, stored in distilled water for a week and thermocycled (5,000 cycles, 5°C to 55°C). They were roughened using 400-grit sandpapers and etched with phosphoric acid. Then, specimens were equally divided into 2 groups; Single Bond Universal (SU) and Prime&Bond Universal (PB). Each group was subdivided into 3 subgroups according to application methods (n = 14); UC: 1 coat + uncuring, 1C: 1 coat + curing, 3C: 3 coats + curing. After storage of the repaired composite for 24 hours, specimens were subjected to the SBS test and the data were statistically analyzed by 2-way analysis of variance and independent t-tests. Specimens were examined with a stereomicroscope to analyze fracture mode and a scanning electron microscope to observe the interface.

Results

Adhesive material was a significant factor (p = 0.001). Bond strengths with SU were higher than PB. The highest strength was obtained from the 1C group with SU. Bonding in multiple layers increased adhesive thicknesses, but there was no significant difference in SBS values (p = 0.255). Failure mode was predominantly cohesive in old composites.

Conclusions

The application of an adequate bonding system plays an important role in repairing composite resin. SU showed higher SBS than PB and the additional layers increased the adhesive thickness without affecting SBS.

Shear-bond strength and optical properties of short fiber-reinforced CAD/CAM composite blocks

The aim of this study was to assess the shear-bond strength (SBS) of resin-luting cement to experimental short fiber-reinforced CAD/CAM composite (SFRC) compared to conventional CAD/CAM (Cerasmart 270), 3D printed (GC TEMP PRINT, Pro3dure GR-17), and laboratory (Gradia Plus) composites. Moreover, translucency parameter values and light transmission were evaluated. For each of the five types of composites, discs were prepared (n = 16/group) and divided into subgroups (n = 8/group) according to surface treatment protocol (hydrofluoric acid or air-particle abrasion). SBS test was performed using universal testing machine until failure, and failure modes were visually analyzed. Translucency parameter and curing-light transmission values through 1, 2, and 3 mm thickness were quantified using spectrophotometry and the MARC resin calibrator, respectively. Scanning electron microscopy (SEM) was used to examine the CAD/CAM composites after surface treatment. Composite type and surface treatment had a significant effect on SBS. Laboratory composite showed the highest SBS value (22.4 MPa). Cerasmart 270 exhibited higher translucency parameter values (19.8, 11.0, 5.0) than SFRC (14.5, 5.2, 1.6) at the three composite thicknesses tested. Air-particle abrasion was more effective in enhancing SBS than acid etching. Experimental SFRC CAD/CAM composite showed higher SBS values than Cerasmart 270. For all composites, translucency parameter values and light transmission decreased as thickness increased.

Repair potential of a bulk-fill resin composite: Effect of different surface-treatment protocols

This study evaluated the effect of different surface-treatment protocols on the repair bond strength of a bulk-fill resin composite. One-hundred and forty specimens (Filtek Bulk-fill) were created (5 mm diameter, 4 mm depth) and allocated to one of 14 groups according to surface treatment (no treatment, tribochemical silica coating, sandblasting with aluminum oxide), adhesive application (no adhesive, total-etch, self-etch), and type of repair resin (bulk-fill, universal resin) (n = 10 per group). Twenty specimens were selected for measuring the cohesive strengths of non-aged resin composites and used as reference. Other specimens were thermocycled. Shear bond-strength testing was performed. Data were analyzed using linear regression of bond strength as a function of the surface treatment, type of adhesive and whether or not adhesive was applied, and type of repair resin. The failure modes were analyzed using logistic regression of failure mode (cohesive failure vs. other types, or adhesive failure vs. other types) on the type of surface treatment, adhesive application, and repair resin used. Surface treatment, regardless of whether this was tribochemical silica coating (mean difference = 5.44 MPa; 95% CI = 4.77-6.11) or sandblasting with aluminum oxide (mean difference = 4.22 MPa; 95% CI = 3.55-4.88), resulted in higher shear bond strength than no treatment. Application of adhesive resulted in a substantial and statistically significant decrease of shear bond strength (by 8.77 MPa, for self-etch and by 7.26 MPa for total-etch) relative to no adhesive. Conversely, the type of repair resin did not influence the shear bond strength to any appreciable extent.

Significance of immediate dentin sealing and flowable resin coating reinforcement for unfilled/lightly filled adhesive systems

BACKGROUND

Immediate dentin sealing implies applying an adhesive system to dentin directly after tooth preparation, before impression. The technique is universal (inlays, onlays, veneers, crowns) and well documented clinically and experimentally. Different types of dentin bonding agents (DBAs) are available on the market. Major differences lie in the thickness of the hybrid layer and overlaying adhesive resin (filled vs. unfilled/lightly filled adhesives).

OBJECTIVE

The objective of this work is to provide precise clinical instructions and present new experimental data about the bond strength of five DBAs (Optibond FL, Scotchbond MP, Single Bond Plus, Clearfil SE Bond, and Scotchbond Universal) used conventionally (dentin sealed at the time of restoration delivery) or with immediate dentin sealing, as well as with an additional flowable resin coating.

METHODS

Seventy-five human molars were selected, restored/tested according the microtensile bond strength method. Fifteen groups (n=5) were obtained from the combination of the five DBAs and three application modes: delayed dentin sealing, immediate dentin sealing and immediate dentin sealing with flowable resin coating.

RESULTS

It appears that immediate dentin sealing was confirmed to significantly improve the bond strength of all tested adhesives. The use of a flowable resin coating reinforcement after immediate dentin sealing increased the microtensile bond strength of all unfilled/lightly filled adhesives (from 233% of increase for ScotchBond MP, up to 560% for Clearfil SE Bond) and maintained the performance of the 3-step golden standard adhesive. Optibond FL used with (52.51 MPa) or without (54.75 MPa) additional flowable resin coating and Clearfil SE Bond (45.64 MPa) used with flowable resin coating provided the best results.

CLINICAL SIGNIFICANCE

The original immediate dentin sealing (IDS) technique implies the use of a filled DBA. With unfilled/lightly filled adhesives, it is suggested to reinforce IDS with an additional flowable resin coating. This seems especially paramount to the performance of simplified adhesive systems to protect the thin bonding interface from oxygen inhibition and preserve IDS layer during predelivery cleaning of the preparation. The clinical reinforcement of unfilled/lightly filled IDS with flowable resin composite is encouraged for more predictable bonding.

Bonding performance of dispersed filler resin composite CAD/CAM blocks with different surface treatment protocols

The effect of various pretreatments on the bonding of a resin cement to resin-composite CAD/CAM blocks (RCBs) was examined. The surface of dispersed-filler RCBs (DF-RCBs) and a polymer infiltrated ceramic network RCB (PICN-RCB) was roughened using hydrofluoric acid etching (HF) or sandblasting, and followed by silanization and/or universal adhesive (UA) application. Microtensile bond strength (µTBS), surface roughness parameters (arithmetical mean height (Sa); developed interfacial area ratio (Sdr)), and critical surface energy (γ_c) were determined. For most DF-RCBs, the highest µTBS was obtained using HF+UA. UA application to DF-RCBs resulted in similar or higher µTBS compared to silanization, which indicates that silane treatment is not crucial for DF-RCBs, especially after HF. In contrast, the highest µTBS to PICN-RCB was obtained with silanization. Both roughening pretreatments significantly increased the surface roughness parameters and the γ_c of all RCBs. The γ_c was positively correlated with Sa (r=0.756, p<0.001) and Sdr (r=0.837, p<0.001).

Chemical and Mechanical Roughening Treatments of a Supra-Nano Composite Resin Surface: SEM and Topographic Analysis

Background: Repairing a restoration is a more advantageous and less invasive alternative to its total makeover. The aim of this study was to analyze the effects of chemical and mechanical surface treatments aimed at increasing the roughness of a supra-nano composite resin. Methods: 27 cylindrical blocks of microhybrid composite were made. The samples were randomly divided into nine groups (n = 3). The samples’ surface was treated differently per each group: acid etching (35% H3PO4, 30 s and 60 s), diamond bur milling, sandblasting and the combination of mechanical treatment and acid etching. The samples’ surface was observed by a scanning electron microscope (SEM) and a confocal microscope for observational study, and surface roughness (Ra) was recorded for quantitative analysis. Results: The images of the samples sandblasted with Al2O3 showed the greatest irregularity and the highest number of microcavities. The surfaces roughened by diamond bur showed evident parallel streaks and sporadic superficial microcavities. No significant roughness differences were recorded between other groups. The difference in roughness between the control group, diamond bur milled group and sandblasted group was statistically significant. (p < 0.01). Comparison between the diamond bur milled group and the sandblasted group was also significant (p < 0.01). Conclusion: According to our results, sandblasting is the best treatment to increase the surface roughness of a supra-nano composite.

Effectiveness of current adhesive systems when bonding to CAD/CAM indirect resin materials: A review of 32 publications

The purpose of this review was to assess the available literature regarding bonding between current adhesive systems and computer-aided design/computer-aided manufacturing (CAD/CAM) indirect resin materials, to provide clinicians with a comparative overview of the relevant bonding procedures. An electronic search was performed through PubMed based on the keywords CAD/CAM and dental bonding. Additional relevant literature was obtained from the citations in the articles. A total of 313 papers were identified, of which 281 were excluded as being unsuitable, and an additional 3 papers were identified, giving a total of 32 articles that are included in this review. Based on this survey, it is recommended that microretentive surfaces should be generated by either blasting or hydrofluoric acid etching. This initial process should be followed by silanization to ensure chemical adhesion prior to bonding to CAD/CAM indirect resin composite materials (including Lava Ultimet, KATANA AVENCIA block, Gradia Block, Cerasmart, Paradigm, and Block HC) and CAD/CAM polymer-infiltrated ceramics (such as Vita Enamic). The use of materials containing methyl methacrylate (MMA) also appears to improve the bonding of CAD/CAM poly(methyl methacrylate) (PMMA) resin materials (including XHIPC-CAD/CAM, artBloc Temp, and Telio).

Effects of different etching strategies on the microtensile repair bond strength of beautifil II giomer material

Background

Considering the differences in the filler particles between giomer and conventional composite resins and the importance of these fillers in the repair bond strength, the aim was to evaluate the effects of different etching strategies with phosphoric acid (PA) and hydrofluoric acid (HF) on the microtensile repair bond strength (µTRBS) of giomer.

Material and Methods

Ten giomer blocks were randomly assigned into 10: 1) control; 2) 37%PA-20s; 3) 3%HF-20s; 4) 3%HF-120s; 5) 9.6%HF-20s; 6) 9.6%HF-120s; 7) 37%PA-20s + 3%HF-120s; 8) 37%PA-20s + 9.6%HF-120s; 9) 3%HF-120s + 37%PA-20s; 10) 9.6%HF-120s + 37%PA-20s. In all groups, the One-Step Plus bonding system was applied and the new giomer block was bonded to the existing giomer. After cross-sectional cutting, 18 samples were prepared from each block and the µTRBS of the samples was measured at a strain rate of 0.5 mm/min. Data were analyzed with one-way ANOVA and post hoc Tukey tests (P<0.05).

Results

The µTRBS in groups 4, 5, 6, 7, 8 and 10 were significantly higher than that in the control group (P<0.05). The µTRBS in group 2 was even less than that in the control group (P<0.001). The highest µTRBS was recorded in group 10, which was significantly different from those in groups 3, 4 and 9 (P<0.05). In addition, the differences between group 9 and groups 6, 7 and 8 were significantly different (P<0.05).

Conclusions

Etching with PA resulted in a decrease in µTRBS. Etching with HF, except for 3%HF-20s and HF after etching with PA, resulted in a significant increase in giomer`s µTRBS. An increase in the application time of 3%HF resulted in a significant increase in the µTRBS.

Key words:Dental restoration repair, Hydrofluoric acid, Phosphoric acid, etching.

Original and Repair Bulk Fracture Resistance of Particle Filler and Short Fiber-Reinforced Composites

OBJECTIVE

This study aimed to evaluate the original (OR) and repair (RR) fracture resistance of a semi-interpenetrating polymer network (semi-IPN)-based short fiber-reinforced composite compared to dimethacrylate-based composite materials by means of the V-notch test.

METHODS AND MATERIALS

Circular specimens (5×2 mm) with a centrally machined 90° V-shaped notch were prepared. Four bulk fill (Filtek Bulk Fill, Venus Bulk Fill, TetricEvo Ceram Bulk Fill, SDR), three microfilled hybrid (GC-Anterior, GC-Posterior, Z250), one nanofilled (SupremeXTE), and two short fiber-reinforced (Alert, everX Posterior) composites were selected. EverX Posterior was the semi-IPN material. Specimens (n=12/group) were either dry or water stored for 7 and 30 days, respectively, at 37°C and then loaded in two-point load until fracture. One-half of each tested specimen was used for the repair procedure. Repairing surfaces were diamond-bur ground, etched, and treated with silane containing universal adhesive (Scotchbond Universal) before repair.

RESULTS

Three-way analysis of variance revealed a significant statistical difference between the groups ( p<0.05). The fracture resistance of dry-stored groups was greater than that of water-stored groups. The highest OR was observed for dry-stored Alert (23.4 N/mm), which significantly deteriorated in water (17.4 N/mm) ( p<0.05). The highest RR was observed for everX Posterior (20.0 N/mm), which did not deteriorate in water significantly (19.0 N/mm) ( p>0.05). The everX Posterior preserved the specimens' integrity at the final fracture load (ductile fracture), whereas all other materials fractured into two halves at the interface (adhesive failure).

CONCLUSIONS

The only material that provided enhanced repair strength that was close to the original cohesive strength of the material was everX Posterior. The endurance of repaired restorations can be improved by using semi-IPN-based filling material.

Repair bond strength of nanohybrid composite resins with a universal adhesive

Objective: To investigate the repair bond strength of fresh and aged nanohybrid and hybrid composite resins using a universal adhesive (UA).

Materials and methods: Fresh and aged substrates were prepared using two nanohybrid (Venus Pearl, Heraus Kulzer; Filtek Supreme XTE, 3 M ESPE) and one hybrid (Z100, 3 M ESPE) composite resin, and randomly assigned to different surface treatments: (1) no treatment (control), (2) surface roughening with 320-grit (SR), (3) SR + UA (iBOND, Heraus Kulzer), (4) SR + Silane (Signum, Ceramic Bond I, Heraeus Kulzer) + UA, (5) SR + Sandblasting (CoJet, 3 M ESPE) + Silane + UA. After surface treatment, fresh composite resin was added to the substrates at 2 mm layer increments to a height of 5 mm, and light cured. Restored specimens were water-stored for 24 h and sectioned to obtain 1.0 × 1.0 mm beams (n = 12), and were either water-stored for 24 h at 37 °C, or water-stored for 24 h, and then thermocycled for 6000 cycles before microtensile bond strength (µTBS) testing. Data were analyzed with ANOVA and Tukey’s HSD tests (p = .05).

Results: Combined treatment of SR, sandblasting, silane and UA provided repair bond strength values comparable to the cohesive strength of each tested resin material (p < .05). Thermocycling significantly reduced the cohesive strength of the composite resins upto 65% (p < .05). Repair bond strengths of UA-treated groups were more stable under thermocycling.

Conclusions: Universal adhesive application is a reliable method for composite repair. Sandblasting and silane application slightly increases the repair strength for all substrate types.

Adhesive system affects repair bond strength of resin composite

Purpose:

This study evaluated the effects of different adhesive systems on repair bond strength of aged resin composites.

Materials and Methods:

Ninety composite discs were built and half of them were subjected to thermal aging. Aged and non-aged specimens were repaired with resin composite using three different adhesive systems; a two-step self-etch adhesive, a two-step total-etch adhesive and a one-step self-etch adhesive; then they were subjected to shear forces. Data were analyzed statistically.

Results:

Adhesive type and aging significantly affected the repair bond strengths (p<0.0001). No statistical difference was found in aged composite groups repaired with two-step self- etch or two-step total-etch adhesive. One-step self-etch adhesive showed lower bond strength values in aged composite repair (p<0.0001).

Conclusion:

In the repair of aged resin composite, two-step self-etch and two-step total-etch adhesives exhibited higher shear bond strength values than that of one-step self-etch adhesive.

Shear bond strength of different surface treatments in bulk fill, microhybrid, and nanoparticle repair resins

Objectives

The purpose of this study was to evaluate the influence of surface treatment and different types of composite resin on the microshear bond strength of repairs.

Materials and methods

Seventy-two specimens (n=72) were prepared using a nanoparticle resin and stored in artificial saliva at 37 ± 1°C for 24 h. After this period, the specimens (n=24) were restored with microhybrid resin P60 (3M ESPE), nanoparticle resin Filtek Z350 (3M ESPE), and Bulk Fill Surefil SDR Flow (Dentsply) composite resins. Previously, the surfaces of the samples were treated, forming the following subgroups (n=12): (A) conditioned with 37% phosphoric acid for 30 s, and (B) abrasioned with a diamond tip for 3 s and conditioned with 37% phosphoric acid. In all groups, before insertion of the composite resin, the adhesive system Adper Single Bond 2 was actively applied and photopolymerized for 20 s.

Results

The microshear test was executed to assess bond strength. Kruskal–Wallis (p<0.05) and Mann–Whitney statistical tests showed significant statistical difference considering that the bulk-fill resin turned out to have a lower bond strength than the conventional nanoparticle and microhybrid composites. With regard to the technique, the roughening with diamond bur followed by the application of phosphoric acid exhibited values higher than the exclusive use of acid.

Conclusion

The microshear bond strength of the composite resin repairs varies in accordance with the type of composite resin utilized, and roughening the surface increased the bond strength of these materials.

Effect of Surface Treatment, Silane, and Universal Adhesive on Microshear Bond Strength of Nanofilled Composite Repairs

Purpose: The aim of this study was to evaluate the effect of surface treatment and universal adhesive on the microshear bond strength of nanoparticle composite repairs.

Methods: One hundred and forty-four specimens were built with a nanofilled composite (Filtek Supreme Ultra, 3M ESPE). The surfaces of all the specimens were polished with SiC paper and stored in distilled water at 37°C for 14 days. Half of the specimens were then air abraded with Al2O3 particles and cleaned with phosphoric acid. Polished specimens (P) and polished and air-abraded specimens (A), respectively, were randomly divided into two sets of six groups (n=12) according to the following treatments: hydrophobic adhesive only (PH and AH, respectively), silane and hydrophobic adhesive (PCH, ACH), methacryloyloxydecyl dihydrogen phosphate (MDP)–containing silane and hydrophobic adhesive (PMH, AMH), universal adhesive only (PU, AU), silane and universal adhesive (PCU, ACU), and MDP-containing silane and universal adhesive (PMU, AMU). A cylinder with the same composite resin (1.1-mm diameter) was bonded to the treated surfaces to simulate the repair. After 48 hours, the specimens were subjected to microshear testing in a universal testing machine. The failure area was analyzed under an optical microscope at 50× magnification to identify the failure type, and the data were analyzed by three-way analysis of variance and the Games-Howell test (α=0.05).

Results: The variables “surface treatment” and “adhesive” showed statistically significant differences for p&lt;0.05. The highest mean shear bond strength was found in the ACU group but was not statistically different from the means for the other air-abraded groups except AH. All the polished groups except PU showed statistically significant differences compared with the air-abraded groups. The PU group had the highest mean among the polished groups. Cohesive failure was the most frequent failure mode in the air-abraded specimens, while mixed failure was the most common mode in the polished specimens.

Conclusions: While air abrasion with Al2O3 particles increased the repair bond strength of the nanoparticle composite, the use of MDP-containing silane did not lead to a statistically significant increase in bond strength. Silane-containing universal adhesive on its own was as effective as any combination of silane and adhesive, particularly when applied on air-abraded surfaces.

Microtensile Bond Strength of Composite Cement to Novel CAD/CAM Materials as a Function of Surface Treatment and Aging

Objectives: To evaluate the effect of different surface treatments on the bond strength to a composite and a polymer-infiltrated ceramic CAD/CAM block after six-month artificial aging.

Methods and Materials: Two types of CAD/CAM blocks (Cerasmart, GC; Enamic, Vita Zahnfabrik) were cut in slabs of 4-mm thickness, divided into six groups, and subjected to the following surface treatments: group 1: no treatment; group 2: sandblasting (SB); group 3: SB + silane (Si); group 4: SB + Si + flowable composite (see below); group 5: 5% hydrofluoric acid etching (HF) + Si; and group 6: 37% phosphoric acid etching (H3PO4) + Si. Sections of the same group were luted together (n=3: 3 sandwich specimens/group) using a dual-cure self-adhesive cement for all groups, except for the sections of group 4 that were luted using a light-curing flowable composite. After three weeks of storage in 0.5% chloramine at 37°C, the sandwich specimens were sectioned in rectangular microspecimens and trimmed at the interface to a dumbbell shape (1.1-mm diameter). One half of the specimens was subjected to a microtensile bond strength (μTBS) test, and the other half was tested after six months of water storage (aging). Data were statistically analyzed with a linear mixed-effects model for the factors surface treatment, material type, and aging, together with their first-degree interactions (α=0.05).

Results: The lowest bond strengths were obtained in the absence of any surface treatment (group 1), while the highest μTBSs were obtained when the surface was roughened by either SB or HF, this in combination with chemical adhesion through Si. Loss in bond strength was observed after six-month aging when either surface roughening or silanization, or both, were omitted.

Conclusions: Both the composite and polymer-infiltrated ceramic CAD/CAM blocks appeared equally bonding-receptive regardless of the surface treatment used. Creating a microretentive surface by either SB or HF, followed by chemical adhesion using Si, is mandatory to maintain the bond strength after six months.

Intraoral Repair of Direct and Indirect Restorations: Procedures and Guidelines

The service life of defective direct or indirect restorations could be prolonged by repair or relayering actions where durable adhesion of resin-based composite materials is established for longevity of repairs. The advances in adhesive technologies have introduced several surface conditioning concepts to adhere resin composites onto different restorative materials. The purpose of this report is to summarize reasons for failure, survival of repaired reconstructions, elaborate upon types and mechanisms of available surface conditioning methods, and present operative dentists with practical guidelines for intraoral repair procedures.

Repair bond strength of dual-cured resin composite core buildup materials

The reparability of dual-cured resin composite core buildup materials using a light-cured one following one week or three months storage, prior to repair was evaluated. Two different dual-cured resin composites; Cosmecore™ DC automix and Clearfil™ DC automix core buildup materials and a light-cured nanofilled resin composite; Filtek™ Z350 XT were used. Substrate specimens were prepared (n = 12/each substrate material) and stored in artificial saliva at 37 °C either for one week or three months. Afterward, all specimens were ground flat, etched using Scotchbond™ phosphoric acid etchant and received Single Bond Universal adhesive system according to the manufacturers' instructions. The light-cured nanofilled resin composite (Filtek™ Z350 XT) was used as a repair material buildup. To determine the cohesive strength of each solid substrate material, additional specimens from each core material (n = 12) were prepared and stored for the same periods. Five sticks (0.8 ± 0.01 mm(2)) were obtained from each specimen (30 sticks/group) for microtensile bond strength (μTBS) testing. Modes of failure were also determined. Two-way ANOVA revealed a significant effect for the core materials but not for the storage periods or their interaction. After one week, dual-cured resin composite core buildup materials (Cosmecore™ DC and Clearfil™ DC) achieved significantly higher repair μTBS than the light-cured nanofilled resin composite (Filtek™ Z350 XT). However, Clearfil™ DC revealed the highest value, then Cosmecore™ DC and Filtek™ Z350 XT, following storage for 3-month. Repair strength values recovered 64-86% of the cohesive strengths of solid substrate materials. The predominant mode of failure was the mixed type. Dual-cured resin composite core buildup materials revealed acceptable repair bond strength values even after 3-month storage.

Effect of Different Surface Treatments and Adhesives on Repair Bond Strength of Resin Composites After One and 12 Months of Storage Using an Improved Microtensile Test Method

Objectives

To evaluate the effect of surface treatments and bonding systems on the repair bond strength between composite materials after one and 12 months of storage, using an improved microtensile test method.

Methods

A total of 72 composite cylinders (Tetric Evo Ceram, Ivoclar) were fabricated, stored in distilled water for two weeks followed by thermal cycling (5000 times between 5°C and 55°C), and served as substrate. The cylinders were mechanically roughened using 320-grit silicon carbide sandpaper, etched with 37% phosphoric acid gel, rinsed with water, and divided equally into three experimental groups: group 1, unchanged surface; group 2, sandblasting of the surface (CoJet tribochemical silica sand, 3M ESPE; Microetcher II, Danville Engineering Inc); and group 3, surface silane coating (Bis-Silane, BISCO Inc). Eight control cylinders were prepared and underwent similar aging as the substrate. Each experimental group was divided into subgroups that received the following bonding systems: one-step self-etching adhesive (AdheSE One, Ivoclar Vivadent), two-step self-etching adhesive (Clearfil SE, Kuraray America), and three-step etch-and-rinse adhesive (Adper Scotchbond Multi-Purpose, 3M ESPE). Fresh composite (Tetric Evo Ceram, Ivoclar) was placed and cured on top of the prepared substrate cylinders. The specimens were placed in distilled water for a week and thermocycled the same way as before. Eight composite control cylinders were also stored and thermocycled for the same period of time. Half of the cylinders in each test group were tested at one month and the second half at 12 months. The cylinders were serially sectioned in an automatic cutting machine, producing 10 to 20 1.1 × 1.1-mm test specimen beam from each cylinder. Specimens were prepared for microtensile testing and the tensile strength calculated based on the force at fracture and specimen dimension. The fracture surfaces were examined under a stereomicroscope and the type of fracture noted.

Results

The mean tensile strength of composite control was 54.5 ± 6.0 MPa at one month and 49.6 ± 5.1 MPa at 12 months. The mean tensile strength for the repaired groups ranged from 26.4 ± 6.8 MPa to 49.9 ± 10.4 MPa at one month and 21.2 ± 9.9 to 41.3 ± 7.5 at 12 months. There was a statistical difference between all groups (p&lt;0.05) at one month. This difference was less pronounced at 12 months. The highest repair strength was obtained in the group having a silane-coated surface and Clearfil, the two-step self-etching adhesive. Clearfil also had the highest repair strength within each surface treatment group. There was a tendency for lower tensile strength at 12 months compared with one month. Most fractures were of the adhesive type; the highest number of cohesive fractures, 16% at one month and 12% at 12 months, were in groups with the highest tensile strength.

Conclusion

The best repair bond strength was achieved by using freshly mixed silane solution on the substrate in addition to an adhesive, rendering a thin bonding layer.

Influence of chemical degradation on the surface properties of nano restorative materials

OBJECTIVES

The aim of this in vitro study was to investigate the effect of chemical degradation on the surface roughness (Ra) and hardness (Knoop hardness number [KHN]) of nano restorative materials.

METHODS

Disc-shaped specimens (5-mm diameter; 2-mm thick) of Filtek Z350 and TPH Spectrum composites and the Vitremer and Ketac Nano light-curing glass ionomer cements were prepared according to the manufacturers' instructions. After 24 hours, polishing procedures were performed and initial measurements of Ra and KHN were taken. The specimens were divided into 12 groups (n=10) according to material and storage media: artificial saliva, orange juice, and Coca-Cola. After 30 days of storage, the specimens were reevaluated for Ra and KHN. The pH values of the storage media were measured weekly. Data were tested for significant differences by repeated-measures three-way analysis of variance and Tukey tests (p<0.05).

RESULTS

Composites were found to present lower roughness values and higher hardness values than the ionomeric materials under all storage conditions. After degradation, the KHN of all experimental samples decreased significantly, while the Ra of the ionomeric materials increased, depending on the media, with a markedly negative impact of Coca-Cola and orange juice. There was no difference among the storage media for Filtek Z350 with regard to the KHN values. Nanofillers did not show any influence on the roughness and hardness of resin-modified glass ionomer cements and resin composites concerning their degradation resistance.

Effect of Different Adhesion Strategies on Bond Strength of Resin Composite to Composite-dentin Complex

Service life of discolored and abraded resin composite restorations could be prolonged by repair or relayering actions. Composite-composite adhesion can be achieved successfully using some surface conditioning methods, but the most effective adhesion protocol for relayering is not known when the composite restorations are surrounded with dentin. This study evaluated the effect of three adhesion strategies on the bond strength of resin composite to the composite-dentin complex. Intact maxillary central incisors (N=72, n=8 per subgroup) were collected and the coronal parts of the teeth were embedded in autopolymerized poly(methyl tfr54methacrylate) surrounded by a polyvinyl chloride cylinder. Cylindrical cavities (diameter: 2.6 mm; depth: 2 mm) were opened in the middle of the labial surfaces of the teeth using a standard diamond bur, and the specimens were randomly divided into three groups. Two types of resin composite, namely microhybrid (Quadrant Anterior Shine; AS) and nanohybrid (Grandio; G), were photo-polymerized incrementally in the cavities according to each manufacturer's recommendations. The composite-enamel surfaces were ground finished to 1200-grit silicone carbide paper until the dentin was exposed. The surfaces of the substrate composites and the surrounding dentin were conditioned according to one of the following adhesion protocols: protocol 1: acid-etching (dentin) + silica coating (composite) + silanization (composite) + primer (dentin) + bonding agent (dentin + composite); protocol 2: silica coating (composite) + acid-etching (dentin) + silanization (composite) + primer (dentin) + bonding agent (dentin + composite); and protocol 3: acid-etching (dentin) + primer (dentin) + silanization (composite) + bonding agent (dentin + composite). Applied primer and bonding agents were the corresponding materials of the composite manufacturer. Silica coating (CoJet sand, 30 μm) was achieved using a chairside air-abrasion device (distance: 10 mm; duration: four seconds in circular motion). After conditioning protocols, the repair resin was adhered to the substrate surfaces using transparent polyethylene molds (diameter: 3.6 mm) incrementally and photo-polymerized. The substrate-adherend combinations were as follows: AS-AS, G-G, AS-G. Shear force was applied to the adhesive interface in a Universal Testing Machine (crosshead speed: 1 mm/min). The types of failures were further evaluated and categorized as follows: 1) cohesive in the composite substrate and 2) adhesive at the interface. Bond strength values (MPa) were statistically analyzed using two-way analysis of variance and least significant difference post hoc tests (α=0.05). Significant effects of the adhesion strategy (p=0.006) and the composite type (p=0.000) were found. Interaction terms were not significant (p=0.292). Regardless of the substrate-adherend combination, protocol 1 (17–22 MPa) showed significantly higher results than did protocols 2 (15–17 MPa) and 3 (11–17 MPa) (p=0.028, p=0.002, respectively). The highest results were obtained from the G-G combination after all three protocols (17–22 MPa). The incidence of cohesive failures was more common when the substrate and the adherend were the same composite type (AS-AS: 87.5%, 87.5%, 75%; G-G: 100%, 75%, 50% for protocols 1, 2, and 3, respectively). When substrate and adherend were used interchangeably, adhesive failures were more frequent (25%, 50%, and 100% for protocol 1, 2, and 3, respectively). When the substrate and the adherend are of the same type, greater repair strength could be expected. In the repair of composites next to the dentin, depending on the composite type, conditioning the composite with silica coating and silanization after etching the dentin adds to the repair strength compared to the results obtained with silane application only.

Effect of Different Surface Treatments on Repair Micro-shear Bond Strength of Silica- and Zirconia-filled Composite Resins

Background and aims

Effect of surface treatments on repair bond strength of aged composite resins might be different due to their dissimilar fillers. The aim was to evaluate the effect of different surface treatments on repair micro-shear bond strength (µSBS) of silica- (Spectrum TPH) and zirconia-filled (Filtek Z250) composite resins.

Materials and methods

Twenty-seven composite resin blocks were made from each type of composite resin: Z250 and Spectrum TPH. After aging, blocks of each type were randomly divided into three groups according to surface treatments: alloy primer, silane, and only surface roughening. Subsequently, each group was further subdivided into 3 subgroups based on the adhesive system used: Single Bond, Clearfil SE Bond, and Margin Bond. Four composite resin columns were added on each block. After thermocycling, µSBStest were done at cross head speed of 0.5 mm/min. Data was analysed using multifactor ANOVA, one-way ANOVA and a post-hoc Bonferroni tests (α = 0.05).

Results

Analysis of data showed that the effect of composite resin type was not significant (p > 0.05), but the effects of the type of surface treatment (p = 0.01) and the type of adhesive system (p = 0.01) were significant on repair µSBS. In addition, the cumulative effect of the composite type-surface treatment and the composite type with the type of adhesive system were not statistically significant (p > 0.05). However, the cumulative effects of the adhesive system-surface treatment (p = 0.03) and the composite type-the adhesive system-surface treatments (p = 0.002) were significant.

Conclusion

Although repair µSBS values of both silica- and zirconia-filled composite resins were similar, use of different combinations of surface treatments and adhesive systems affected their repair µSBS differently.

An in vitro comparison of four intra-oral ceramic repair systems

OBJECTIVES

This study evaluated the effect of different surface conditioning methods on the tensile bond strength (TBS) and integrity of the leucite-reinforced glass ceramic (Cerana(®) inserts)-resin composite interface, using four commercially available ceramic repair systems.

METHODS

Two hundred extra-large Cerana(®) inserts were mechanically treated and stored in artificial saliva for 3 weeks and subsequently randomly assigned to one of the following ceramic repair systems (n=40/group): Group 1, Ceramic Repair(®) (Ivoclar Vivadent, Liechtenstein); Group 2, Cimara(®) (Voco, Germany); Group 3, Clearfil Repair(®) (Kuraray, Japan); Group 4, CoJet system(®) (3M ESPE, Germany); and Group 5, no surface conditioning and no adhesive system applied: the control group. Subsequently, resin composite material was added to the substrate surfaces and the ceramic-resin composite specimens were subjected to TBS testing. Representative samples from the test groups were subjected to scanning electron microscopy (SEM) to determine the mode of failure. The data were analysed statistically using a one-way multivariate analysis of variance and Kruskal-Wallis test at a 95% confidence interval level.

RESULTS

Surface conditioning with the CoJet(®) system resulted in significantly higher bond strength values (5.2 ± 1.1 MPa) than surface conditioning with the other repair systems (p=0.03). The SEM examination of the failed interfaces revealed that all the specimens examined failed adhesively.

SIGNIFICANCE

Whilst highest bond strength values were observed with the CoJet(®) system all tested repair systems resulted in relatively weak TBS values and, as a consequence, these repair systems may be indicated only as interim measures.

The influence of long term water immersion on shear bond strength of amalgam repaired by resin composite and mediated by adhesives or resin modified glass ionomers

OBJECTIVE

To assess the shear bond strength between amalgam and resin composite mediated by either multipurpose adhesive systems or RMGI when subjected to long term immersion in saline.

METHODS

Part I: Cylindrical specimens (6 mm × 6 mm) composed of equal parts of sandblasted set amalgam (Oralloy) and composite (Z-100), with a thin layer of either Scotchbond Multipurpose, All Bond 2, Amalgam Bond Plus, High Q Bond Plus or Vitrebond in between were fabricated (n = 100 × 5). Each group was divided into 3 subgroups, immersed in saline at 37 °C for either 48 h, 3 or 6 months, followed by thermocycling (5000; 5/55 °C) and shear bond strength testing (SBS). Part II: Identical specimens were fabricated with intermediary of either Ketac Cem, Fuji Lining LC, Rely X Luting, Fuji Plus or Meron Plus (n = 100 × 5). Immersion periods, followed by thermocycling and SBS testing as in Part I. Two representative specimens from each subgroup were sectioned and inspected under SEM.

RESULTS

The two classes of intermediary agents yielded SBS which differed mainly in the 6 months incubation period. While multipurpose adhesives provided SBS values of ~9-10 MPa RMGI provided higher SBS of ~16 MPa. All Bond 2 and Amalgam Bond Plus exhibited deterioration of SBS during the 6 month period as well as Rely X Luting. Gap sizes between 0.5 and 3 μm exist between all intermediaries and the amalgam; on the other hand all intermediaries exhibit gap-free interfaces between the adhesives/RMGI and the composite.

CONCLUSIONS

Vitrebond in particular and RMGIs in general can serve as an excellent coupler of resin composite to amalgam, providing a durable bond.

Durability of composite repair using different surface treatments

OBJECTIVE

To evaluate the surface treatment and hydrophilicity of the bonding agent on the composite repair strength (RS), silver nitrate uptake (SNU), surface roughness (SR) and estimation of surface area (SA).

METHODS

Fifty resin blocks (Opallis, FGM) were polished and divided in 5 groups: no treatment (NT); roughening with a fine (FDB); medium (MDB); coarse-grit (CDB) and 50-μm aluminium oxide sandblasting (AO). A hydrophobic (Adhesive, Scotchbond Multi-Purpose Plus, 3M ESPE) or hydrophilic (Adper Single Bond 2, 3M ESPE) adhesive was applied, followed by composite placement (Opallis, FGM). Composite-composite bonded sticks (0.9 mm2) were tested in tension (1.0mm/min) immediately [IM] or after 6 months [6M] of water storage. Two sticks from each tooth, at each time, were immersed in a 50% silver nitrate solution and evaluated by SEM. A profilometer was used to measure SR. SEM images were used to estimate the SA using the Image J software. Data were analysed by ANOVA and Tukey's tests.

RESULTS

The AO showed the highest CR strength for both adhesives, whilst the NT group showed the lowest, irrespective of the storage period. The diamond burs had intermediate performance. Silver nitrate deposits were seen after 6M for the hydrophilic adhesive. The ranking of SR values (Ra) from the lowest to the highest was: NT<FDB<MDB<AO≤CDB. A higher SA was produced by AO treatment.

CONCLUSIONS

The AO treatment provides the highest CR strength likely due to the high SA produced. The bonding agent did not seem to affect the CR strength after 6M, although early signs of degradation were detected for the hydrophilic system.

CLINICAL SIGNIFICANCE

Polished composite should be preferred roughened with aluminium oxide followed by the application of a hydrophobic intermediate agent before composite repair.

Restorative material and other tooth-specific variables associated with the decision to repair or replace defective restorations: findings from The Dental PBRN

OBJECTIVES

Using data from dentists participating in The Dental Practice-Based Research Network (DPBRN), the study had 2 main objectives: (1) to identify and quantify the types of restorative materials in the existing failed restorations; and (2) to identify and quantify the materials used to repair or replace those failed restorations.

METHODS

This cross-sectional study used a consecutive patient/restoration recruitment design. Practitioner-investigators recorded data on consecutive restorations in permanent teeth that needed repair or replacement. Data included the primary reason for repair or replacement, tooth surface(s) involved, restorative materials used, and patient demographics.

RESULTS

Data for 9875 restorations were collected from 7502 patients in 197 practices for which 75% of restorations were replaced and 25% repaired. Most of the restorations that were either repaired or replaced were amalgam (56%) for which most (56%) of the material used was direct tooth-coloured. The restorative material was 5 times more likely to be changed when the original restoration was amalgam (OR=5.2, p<.001). The likelihood of changing an amalgam restoration differed as a function of the tooth type (OR=3.0, p<.001), arch (OR=6.6, p<.001); and number of surfaces in the original restoration (OR=12.2, p<.001).

CONCLUSION

The probability of changing from amalgam to another restorative material differed with several characteristics of the original restoration. The change was most likely to take place when (1) the treatment was a replacement; (2) the tooth was not a molar; (3) the tooth was in the maxillary arch; and (4) the original restoration involved a single surface.