Weibull parameters of composite resin bond strengths to porcelain and noble alloy using the Rocatec system

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

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

Do different protocols affect the success rate or bond strength of glass-ceramics repaired with composite resin? A systematic review and meta-analysis

STATEMENT OF PROBLEM

Intraoral repair techniques prevent unnecessary replacement of ceramic restorations, thereby increasing the survival rate. However, adhesion between ceramics and the composite resin is challenging and how different protocols influence adhesion is unclear.

PURPOSE

The purpose of this systematic review and meta-analysis was to analyze the influence of different protocols on repairing glass-ceramic surfaces with composite resins.

MATERIAL AND METHODS

PubMed, Scopus, ISI Web of Science, and Embase electronic databases were searched to select studies comparing bond strength values or survival rates of glass-ceramic repaired with composite resins using different surface treatment protocols. No publication year or language restriction was applied. Data sets were extracted from all included studies, and the mean differences calculated. A 95% confidence interval was calculated by using the random effect model (Rev Man 5.4).

RESULTS

The search identified 5037 studies, and 165 were assessed for eligibility. Finally, 123 in vitro studies were included in the systematic review and 48 in the meta-analysis. Considering different glass-ceramics, bond strength tests, and aged or not aged specimens, 37 meta-analyses found the effect of repair protocols: only adhesive, silane plus adhesive alone or preceded by hydrofluoric (HF) acid, airborne-particle abrasion (APA) with Al2O3 particles, silica-coated APA (SCAPA), diamond rotary instrument (DRI), and laser irradiation (LI).

CONCLUSIONS

For feldspathic porcelain, HF acid, APA, SCAPA, or DRI improved the repair micromechanical retention; applying silane is essential to HF-conditioned surfaces but the use of adhesive is optional when silane is applied. Results for leucite and lithium disilicate were inconclusive in terms of suggesting a treatment other than HF acid plus silane and adhesive applications.

Appropriate Immediate Dentin Sealing to Improve the Bonding of CAD/CAM Ceramic Crown Restorations

This study aimed to use quantitative and qualitative evaluations based on micro-tensile bond strength (μTBS) to clarify the appropriate immediate dentin sealing (IDS) approach for improving the bonding of CAD/CAM ceramic crown restorations. Forty-eight extracted human molars were prepared to obtain standardized abutment specimens and divided into three groups: no IDS (group C: control), IDS performed by a single application of an all-in-one adhesive system (group A), and IDS performed by the combined application of an adhesive system and a flowable resin composite (group F). All specimens were restored with a ceramic crown fabricated by a chair-side CAD/CAM system and were divided into no-stress and stressed groups. After cyclic loading (78.5 N; total, 3 × 105 cycles; 90 cycles/min) on the specimens in the stressed group, all specimens were sectioned. The μTBS values for the occlusal and mesioaxial walls were measured (n = 16) and analyzed statistically. The quantitative bonding performance of groups A and F were superior to that of group C, regardless of the cyclic loading and abutment wall conditions. Group F showed the maximum bond strength and the highest bond durability in the qualitative bonding performance even under the cyclic loading condition simulating clinical mastication.

Retentive Strength of CAD/CAM-Fabricated All-Ceramic Crowns Luted on Titanium Implant Abutments Using Different Ceramic Materials and Luting Agents: An In Vitro Study

Objectives: This study aimed to determine the retentive strength of monolithic hybrid-all-ceramic crowns luted on titanium implant abutments. Material and Methods: In total, 450 crowns (75 each of Mark II, Empress CAD, e.max CAD, Suprinity, Enamic, Celtra Duo) were milled using a CAD/CAM system. The crowns were cemented onto sandblasted titanium implant abutments using five luting agents (Multilink Implant, Variolink II, RelyX Unicem, Fujicem, and Panavia 2.0). After thermocycling was performed (5000 cycles: 5−55 °C, 30-s dwell time), the crowns were removed using a universal testing machine. The location of luting-agent residue on the abutment and inner crown surfaces was evaluated. Analyses of variance (ANOVA) with the Bonferroni correction were performed to evaluate differences of retentive strength depending on the crown material and the kind of the luting agent. Results: The retentive strengths for the different ceramic materials were Vita Mark II: 652N-759N (SD:134N-146N), Empress CAD: 681N-822N (SD: 89N-146N), e.max CAD: 784N-1044N (SD: 109N-176N), Vita Enamic: 716N-1177N (SD: 132N-220N), Vita Suprinity: 867N-1488N (SD: 202N-278N), and Celtra Duo 772N-1335N (SD:151N-229N). After the removal trials, the visual documentation showed different adhesive residue location depending on the ceramic materials. Furthermore, the pull-off force was dependent on the choice of adhesives. No significant differences were found between different luting agents and the ceramic material Vita Mark II and Empress CAD. EmaxCAD showed significant differences with Unicem and FujiCem compared to Panavia, as did VitaSuprinity, VitaEnamic, and Celtra Duo (p < 0.001). Conclusions: The ceramic material used seems to influence the retentive strength and the use of certain luting agents results in a higher retentive strength for some ceramic materials.

Flexural properties of three lithium disilicate materials: An in vitro evaluation

Objective

The goal of this study was to investigate the flexural strength, Young’s modulus and Weibull modulus of two heat-pressed and one CAD/CAM processed lithium disilicate (LD) ceramics.

Material and methods

A total of 45 specimens with dimensions 16 × 4 × 1.2 ± 0.2 mm were fabricated out of three LD ceramics. For heat-pressed LD specimens, acrylate polymer blocks were cut and divided into two groups (n = 15 per group); a GC LiSi Press LD group (LP) and an IPS e.max Press group (EP). Specimens for each group were pressed corresponding to the manufacturer’s recommendations. For the CAD-CAM Group (EC), IPS e.max CAD blocks were cut to obtain specimens (n = 15) to the desired dimensions. Flexural strength and Young’s modulus tests were executed using a universal testing machine. A one-way ANOVA and post-hoc Tuckey’s tests were applied to analyze the results (p ≤ 0.05).

Results

Regarding flexural strength, the EC group showed higher statistically substantial difference than the EP and LP groups (p = 0.001), while there was no pronounced difference between the EP and LP groups (p = 0.065). For Young’s modulus test, all the three tested groups had no statistically substantial difference (p = 0.798).

Conclusion

The IPS e.max CAD group had higher mechanical performance than the IPS e.max Press and GC LiSi Press groups.

Bonding States of In Vitro Class 2 Direct Resin Composite Restoration Applied by Various Incremental Techniques

Incremental techniques are always required for clinical cases of deep and/or large cavities restored with resin composite materials. The purpose of this study was to examine the bonding states of class 2 direct resin composite restoration applied by various incremental techniques after cyclic loading to simulate the intra-oral environment to define the appropriate technique. Three types of resin composites, namely, bulk-fill (B), flowable (F), and conventional resin composite (C), were applied to standardized class 2 cavities by incremental techniques with single- or bi-resin restoratives. After cyclic loading, the micro-tensile bond strength (μ-TBS) of the dentin cavity floor was measured. The Weibull modulus and Weibull stress values at 10%/90% probability of failure were analyzed. Single-resin incremental restorations with B or F and bi-resin incremental restorations with F + B and F + C demonstrated superior μ-TBS (quantitative ability), bonding reliability, and durability (qualitative ability) compared with the single-resin restoration with C (as control). Furthermore, F + B and F + C restoration yielded an excellent performance compared with the single-resin restorations with B, F, and C. In particular, the F + C restoration, which indicates not only the maximum mean µ-TBS, but also the highest values of the Weibull parameters, may be the optimal restoration method, including the esthetic benefits.

The effect of space setting values and restorative block materials on the bonding of metal-free CAD/CAM onlay restorations

The effects of space setting values and restorative materials on the bonding of metal-free CAD/CAM onlay restoration were examined quantitatively and qualitatively. Seventy-two standardized MODB onlay cavities, prepared using human molars were restored under nine conditions, based on three space setting values, Increased (IC), Standard (SC, control), Decreased (DC), and three restorative block materials, resin-composites (RC), lithium disilicate glass-ceramics (LD), Feldspar ceramics (FC, control). All the restored specimens were subjected to cyclic loading and thereafter the microtensile bond strength (µ-TBS) was measured and analyzed statistically. The effect of space setting value on the µ-TBS varied with the restorative material. The bonding reliability of RC and the bonding durability of LD were significantly superior to FC. The bonding characteristics of RC under IC and DC were similar to those under SC. LD under DC and FC under IC were effective in obtaining an excellent bonding reliability relative to their SC.

Effect of natural primer associated to bioactive glass-ceramic on adhesive/dentin interface

OBJECTIVES

This study evaluated the effect of propolis associated with Biosilicate on the bond strength (BS) and gelatinolytic activity at the adhesive/dentin interface.

METHODS

Occlusal cavities were prepared in 320 human molars. Half of them were submitted to cariogenic challenge. All the teeth were separated into eight groups (n = 20): Control - Adhesive System (Single Bond Universal, 3 MESPE); CHX - 0.12 % Chlorhexidine; Bio - 10 % Biosilicate; P16 - Propolis with low levels of polyphenols; P45 - Propolis with high levels of polyphenols; CHX Bio - CHX + Bio; P16 Bio - P16+Bio; P45 Bio - P45+Bio. The adhesive was applied (self-etch mode) after treatments. Restorations (Filtek Z350, 3 MESPE) were performed and samples sectioned into sticks, separated and stored in distilled water at 37 °C for 24 h, 6 months and 1 year. Microtensile BS (0.5 mm/min) was tested and analyzed (2-way ANOVA, Bonferroni's Test, p < .05 and Weibull analysis). Fracture patterns (VH-M100, Keyence) and adhesive interfaces (SEM, EVO-MA10, ZEISS and TEM, JEM-1010, JEOL) were observed; and biodegradation and in situ zymography performed.

RESULTS

P16 presented the highest BS values on sound dentin after 6 months. In caries-affected dentin (CAD), the association of treatments promoted the highest BS after 24 h. Sound dentin obtained significantly higher Weibull modulus than CAD. SEM displayed resin tags in P16, P45 and association of treatments. TEM showed good interaction between adhesive and dentin. According to the in situ zymography and biodegradation assay all natural primers reduced the gelatinolytic activity. P45 presented the lowest biodegradation and enzymatic activity.

CONCLUSIONS

Propolis and the association of treatments promoted the highest bond strength results and preserved the dentin. All the experimental groups exhibited low gelatinolytic activity.

CLINICAL SIGNIFICANCE

Propolis and the association of treatments with Biosilicate could preserve the dentin substrate and improve the longevity of composite restorations.

Reliability of Different Bending Test Methods for Dental Press Ceramics

Objective: This study investigates the reliability of different flexural tests such as three-point-bending, four-point bending, and biaxial tests, in strengthening the dental pressed ceramics (DPCs) frequently used in clinical applications. Methods: The correlations between the three types of bending tests for DPCs were investigated. Plate-shaped specimens for the three-point and four-point bending tests and a disc-shaped specimen for the biaxial bending test were prepared. Each bending test was conducted using a universal testing machine. Results: The results for six DPCs showed that the flexural strength in descending order were the three-point flexural strength, biaxial flexural strength, and four-point flexural strength, respectively. Then, a regression analysis showed a strong correlation between each of the three test methods, with the combination of four-point and biaxial flexural strength showing the highest values. The biaxial flexural strength was not significantly different in the Weibull coefficient (m) compared to the other tests, with the narrowest range considering the 95% interval. The biaxial bending test was found to be suitable for materials with small plastic deformation from the yield point to the breaking point, such as DPCs.

Enhanced mechanical properties of ZrO2-Al2O3 dental ceramic composites by altering Al2O3 form

OBJECTIVES

This study evaluates the difference in physical and mechanical properties of ZrO₂ ceramics, commonly used in dental applications, altered by three different forms of Al₂O₃ content; microparticles (m), nanoparticles (n), and microfiber (f).

METHODS

Three different types of ZrO₂-Al₂O₃ composites were formed using microparticle (m), nanoparticle (n), or microfibre (f) forms of Al₂O₃. The physical and mechanical properties such as sintering shrinkage, relative density, Vickers hardness, fracture toughness, and biaxial strength were evaluated. A Weibull analysis was performed to assess the strength reliability of the specimens. All data were calculated using the t-test and ANOVA.

RESULTS

The sintering shrinkage and relative density of all ceramic composite groups were decreased with the addition of Al₂O₃. The mechanical properties of ZrO₂-Al₂O₃ (f) composite were higher than that of ZrO₂-Al₂O₃ (m) composite and ZrO₂-Al₂O₃ (n) composite. The maximum hardness, fracture toughness, and biaxial flexural strength were observed for 10 vol% of Al₂O₃ fibre. When the content of Al₂O₃ fibre in the matrix was increased above 20 vol%, agglomeration occurred and resulted in a decrease of hardness and toughness. The Weibull modulus value of the ZrO₂-Al₂O₃ (f) composite was the lowest compared to that of other groups. However, characteristic strength (σ₀) of ZrO₂-Al₂O₃ (f) the highest value.

SIGNIFICANCE

The current study demonstrated that the addition of right amount of Al₂O₃ microfibre into the ZrO₂ matrix enhanced the mechanical properties of ZrO₂-Al₂O₃ (f) composite, which would be favourable for dental applications.

Influence of immediate dentin sealing and temporary restoration on the bonding of CAD/CAM ceramic crown restoration

This study examined the influences of clinical application of immediate dentin sealing (IDS) and temporary restoration (TR) on prepared abutment surfaces on the bonding of computer-aided design/computer-aided manufacturing (CAD/CAM) ceramic crown restorations after cyclic loading. Standardized abutments were prepared in 60 human mandibular premolars. Dentin surfaces of half of the specimens were sealed with adhesive and flowable composite, while those of the other half were not sealed. A half of both sealed and non-sealed specimens were restored using a temporary cement and temporary crown. Each individual CAD/CAM ceramic crown was fabricated and cemented to an individual abutment. The restored specimens were subjected to cyclic loading, and the micro tensile bond strengths (μ-TBS) were measured. IDS contributed to an increase in the bond strength, whereas TR did not affect the bond strength. IDS restoration without TR yielded the maximum bond reliability in achieve specific μ-TBS values for the restoration and ensuring durability against debonding.

Effect of Surface Treatments on Shear Bond Strength of Polyetheretherketone to Autopolymerizing Resin

These days, new prosthodontic materials are appearing with the development of digitalization. Among these, the use of polyetheretherketone (PEEK) as the clasp of removable partial dentures has been proposed. The adhesive strength between the PEEK and acrylic resin influences the probability of denture fracture. To investigate the effect of PEEK surface treatments on the shear bond strength to acrylic resin, five surface treatment conditions of PEEK were analyzed: 1. no treatment; 2. ceramic primer application; 3. Al₂O₃ sandblasting; 4. Rocatec; and 5. Rocatec with ceramic primer application, comparing with a metal primer-treated Co-Cr alloy. Two kinds of autopolymerizing resin (Unifast II and Palapress Vario) were used as bonding materials. The specimens were evaluated to determine the bond strength. Rocatec treatment with ceramic primer application yielded the highest bond strengths (12.71 MPa and 15.32 MPa, respectively, for Unifast II and Palapress Vario). When compared to a metal primer-treated Co-Cr alloy, the bond strength of PEEK to Unifast II was similar, whereas it was about 60% of that to Palapress Vario. Rocatec treatment, combined with ceramic primer, showed the highest bond strength of PEEK to acrylic resin. Treatment of PEEK will enable its use as the clasp of removable dentures and the fixation of PEEK prostheses.

Improved resin-to-dentin bond strength and durability via non-thermal atmospheric pressure plasma drying of etched dentin

This study aimed to evaluate the improvement in strength and durability of the bond between dentin and composite resins following plasma drying of the etched dentin surface using non-thermal atmospheric pressure plasma. Plasma drying was applied to the etched dentin before applying adhesive. Conventional wet-bonding and helium (He) gas-dried bonding schemes were used as control groups. The bond strength of the composite resin to dentin was measured as the microtensile bond strength at 24 h after bonding and after 10,000 cycles of thermocycling. Hybrid layer formation was observed using micro-Raman spectroscopy and scanning electron microscopy. Although the bond-strength values were not statistically different either at 24 h after bonding or after thermocycling, the bond strength of the plasma-dried bonding group was significantly higher than the conventional wet-bonding group and He gas-dried bonding group. Micro-Raman spectral analysis revealed effective penetration of the adhesive and an improved polymerization rate of the adhesive after plasma drying. Plasma drying increased the penetration of hydrophobic resin into the collagen mesh structure, which improved mechanical bonding and long-term durability between dentin and composite resin.

Effect of immediate dentin sealing applications on bonding of CAD/CAM ceramic onlay restoration

The effects of immediate dentin sealing (IDS) applications on the bonding of computer-aided design/computer-aided manufacturing (CAD/CAM) ceramic onlay restorations after cyclic loading were examined. Standardized mesial-distal-occlusal-palatal cavities in 32 extracted human molars were prepared. The cavities were divided into four groups: those receiving thin-layered (T), slope-shaped (S), and base-shaped (B) sealing, and the non-sealing group (N) as a control. The intra-cavity dentin walls of the T, S, and B groups were sealed with an all-in-one adhesive and a flowable composite. All cavities were scanned; hence, CAD/CAM onlays were fabricated using ceramic blocks and bonded with a resin cement system. Cyclic loading was applied and the microtensile bond strength (μ-TBS) was measured. It was found that IDS application improved not only the μ-TBS, but also the bonding reliability and durability of the CAD/CAM restoration. In particular, the S restoration exhibited the highest-performance as regards both robust bond strength and stable bonding.

The Effect of Various Types of Mechanical and Chemical Preconditioning on the Shear Bond Strength of Orthodontic Brackets on Zirconia Restorations

The purpose of this study was to investigate the combined effect of mechanical and chemical treatments on the shear bond strength (SBS) of metal orthodontic brackets on zirconia restoration. The zirconia specimens were randomly divided into 12 groups (n = 10) according to three factors: AL (Al₂O₃) and CO (CoJet™) by sandblasting material; SIL (silane), ZPP (Zirconia Prime Plus), and SBU (Single Bond Universal) by primer; and N (not thermocycled) and T (thermocycled). The specimens were evaluated for shear bond strength, and the fractured surfaces were observed using a stereomicroscope. Scanning electron microscopy images were also obtained. CO-SBU combination had the highest bond strength after thermocycling (26.2 MPa). CO-SIL showed significantly higher SBS than AL-SIL (p < 0.05). CO-ZPP resulted in lower bond strength than AL-ZPP before thermocycling, but the SBS increased after thermocycling (p > 0.05). Modified Adhesive Remnant Index (ARI) scoring and SEM figures were consistent with the results of the surface treatments. In conclusion, CO-SBU, which combines the effect of increased surface area and chemical bonding with both 10-MDP and silane, showed the highest SBS. Sandblasting with either material improved the mechanical bonding by increasing the surface area, and all primers showed clinically acceptable increase of shear bond strength for orthodontic treatment.

Bonding of flowable resin composite restorations to class 1 occlusal cavities with and without cyclic load stress

To examine the bonding of flowable resin composite restorations (F-restoration) to class 1 occlusal cavities with and without cyclic load stress, compared with that of a universal resin composite restoration (U-restoration). Two flowable composites and one universal composite (control) were applied with an adhesive system to 42 standardized class 1 occlusal cavities. The restored specimens were subjected to cyclic load stress and no stress modes. The microtensile bond strength (μ-TBS) of the dentin floor was measured. The U-restoration did not show pretesting failure. The F-restorations exhibited pretesting failure, regardless of the stress mode. The μ-TBS was not significantly different among the three restorations, regardless of the stress mode. The cyclic load stress did not influence the μ-TBS of the F-restorations; however, it significantly reduced μ-TBS in the U-restoration. The bonding reliability of the F-restorations was inferior to that of the U-restoration, for both stress modes.

New Concept of Polymethyl Methacrylate (PMMA) and Polyethylene Terephthalate (PET) Surface Coating by Chitosan

Chitosan is known for its hemostatic and antimicrobial properties and might be useful for temporary coating of removable dentures or intraoral splints to control bleeding after oral surgery or as a supportive treatment in denture stomatitis. This study investigated a new method to adhere chitosan to polymethyl methacrylate (PMMA) and polyethylene terephthalate (PET). There were 70 cylindrical specimens made from PMMA and 70 from PET (13 mm diameter, 6 mm thickness). The materials with ten specimens each were sandblasted at 2.8 or 4.0 bar with aluminum oxide 110 μm or/and aluminum oxide coated with silica. After sandblasting, all specimens were coated with a 2% or 4% acetic chitosan solution with a thickness of 1 mm. Then the specimens were dried for 120 min at 45 °C. The precipitated chitosan was neutralized with 1 mol NaOH. After neutralization, all specimens underwent abrasion tests using the tooth-brushing simulator with soft brushes (load 2N, 2 cycles/s, 32 °C, 3000 and 30,000 cycles). After each run, the specimen surfaces were analyzed for areas of remaining chitosan by digital planimetry under a light microscope. The best chitosan adhesion was found after sandblasting with aluminum oxide coated with silica (U-Test, p < 0.05) in both the PMMA and the PET groups. Hence, with relatively simple technology, a reliable bond of chitosan to PMMA and PET could be achieved.

Porcelain repair - Influence of different systems and surface treatments on resin bond strength

PURPOSE

The purpose of this study was to evaluate the bond strength of composite resin on the fracture surface of metal-ceramic depending on the repair systems and surface roughening methods.

MATERIALS AND METHODS

A total of 30 disk specimens were fabricated, 15 of each were made from feldspathic porcelain and nickel-chromium base metal alloy. Each substrate was divided into three groups according to the repair method: a) application of repair system I (Intraoral Repair Kit) with diamond bur roughening (Group DP and DM), b) application of repair system I with airborne-particle abrasion (Group SP and SM), and c) application of repair system II (CoJet Intraoral Repair System, Group CP and CM). All specimens were thermocycled, and the shear bond strength was measured. The data were analyzed using the Kruskal-Wallis analysis and the Mann-Whitney test with a significance level of 0.05.

RESULTS

For the porcelain specimens, group SP showed the highest shear bond strength (25.85 ± 3.51 MPa) and group DP and CP were not significantly different. In metal specimens, group CM showed superior values of bond strength (13.81 ± 3.45 MPa) compared to groups DM or SM.

CONCLUSION

Airborne-particle abrasion and application of repair system I can be recommended in the case of a fracture localized to the porcelain. If the fracture extends to metal surface, the repair system II is worthy of consideration.

Intraoral treatment of veneering porcelain chipping of fixed dental restorations: a review and clinical application

BACKGROUND

Every dental ceramic system can experience failure of the veneering porcelain. However, the increasing popularity of all-ceramic crowns and fixed dental prostheses (FDPs) seems to have led to an increasing need to repair chipped veneering porcelain.

OBJECTIVES

The authors compared different methods to repair fractured ceramic restorations (porcelain-fused-to-metal and all-ceramic) and explain the basic principles of adhesion in these systems. They also evaluated the frequency and causes of failure in dental ceramic systems.

METHODS

This review is based on the results of PubMed and Google Scholar searches, as well as on a hand search of the scientific literature, resulting in 300 articles from 1977 to 2012. The authors used multiple key words (ceramic, repair, bonding, hydrofluoric acid, air abrasion, silane, phosphates, silicon dioxide) and different strategies (connecting different key words with OR, NOR and AND and truncation of the stem of words) to search the databases.

RESULTS

Because of differences in the material composition of ceramic systems (composed of metal, alumina or zirconia, glass-ceramics and feldspathic ceramics), different treatments are required for the exposed material surfaces after chipping. Use of hydrofluoric acid etching, air abrasion, tribochemical coating, silanization and metal primers or zirconia primers seem to be the most successful conditioning methods for durable bonding and repair.

CONCLUSIONS AND CLINICAL IMPLICATIONS

Intraoral repair of a restoration offers a satisfying option for the patient when the restoration cannot be removed or replaced. Its success depends largely on the conditioning methods used for the fractured surfaces.

Effect of Biofilm on the Repair Bond Strengths of Composites

Composite restorations degrade during wear, but it is unknown how wear affects the composite surface and influences composite-to-composite bonding in minimally invasive repair. Here, it is hypothesized that in vitro exposure of composites to oral biofilm yields clinically relevant degradation of composite surfaces, and its influence on composite-to-composite bonding is determined. Biofilms on composite surfaces in vitro increased their roughness and decreased filler particle exposure, except for a microhybrid composite, similar to effects of clinical wear in palatal appliances. Failure shear stresses after intermediate-adhesive-resin application were significantly lower after aging by in vitro exposure to biofilms, while silica-coating maintained the same failure stress levels as in non-aged composites. Failure modes were predominantly cohesive after silica-coating, while intermediate-adhesive-resin application yielded more adhesive failure. It is concluded that in vitro exposure to oral biofilm is a clinically relevant aging condition, and that silica-coating is to be preferred for the repair of aged composites.

Microtensile bond strength of fiber-reinforced composite with semi-interpenetrating polymer matrix to dentin using various bonding systems

This study investigated the microtensile bond strength (microTBS) of fiber-reinforced composite (FRC) to dentin using various adhesive systems. Forty eight (n = 8/group) human molars were flattened to expose dentin. A layer of preimpregnated unidirectional FRC (everStick) was applied on the dentin surface after treatment with either a single-step self-etching adhesive, two-step self-etching system, or a conventional three-step adhesive system. For the control, particulate filler composite (PFC) (Filtek Z250) layering without FRC was used. After 24-hour water storage at 37 degrees C, the specimens were sectioned, further water-stored at 37 degrees C for 30 days and then tested. Data were analyzed using ANOVA and Tukey's test, and reliability was analyzed with Weibull distribution. microTBS values differed significantly according to the adhesive material used (p < 0.05). Single-step self-etching adhesive showed the lowest bond reliability and microTBS values with both FRC and PFC, whereas conventional three-step and two-step self-etching systems showed higher bond reliability and microTBS with both materials.

Effect of operating air pressure on tribochemical silica-coating

OBJECTIVE

Alumina and zirconia are inert to conventional etching and need to be initially conditioned with, for example, silicatization. The aim of the present study was to evaluate the effect of operating air pressure of tribochemical silica-coating method on the shear bond strength of composite resin to ceramic substrates.

MATERIAL AND METHODS

Alumina (Procera Alumina, Nobel Biocare) and zirconia (LAVA; 3M ESPE and Procera Zirconia; Nobel Biocare) were airborne particle silica-coated (CoJet; 3M ESPE) using selected, clinically available air pressures of 150, 220, 300, and 450 kPa. The surfaces were silanized with silane coupling agent (ESPE Sil; 3M ESPE) and coated with adhesive resin (3M Multipurpose resin; 3M ESPE). Particulate filler resin composite (Z250; 3M ESPE) stubs (diameter 3.6 mm, height 4.0 mm) were added onto ceramics and light-cured for 40 s. The test specimens (n=18/group) were thermocycled (6000 x 5-55 degrees C) and shear bond strengths were measured with a cross-head speed of 1.0 mm/min. Fracture surfaces were examined with SEM, and an elemental analysis (EDS) was carried out to determine silica content on the substrate surface.

RESULTS

The highest bond strengths were obtained with the highest pressures. ANOVA showed significant differences in bond strength between the ceramics (p<0.05) and between the specimens treated at various air pressures (p<0.05).

CONCLUSIONS

Clinically, the operating air pressure of silicatization may have a significant effect on bond strength to non-etchable ceramics.

Resin-dentin bond strength as related to different surface preparation methods

OBJECTIVE

To determine the microtensile bond strength and micromorphological structures on bonding of two adhesives (OptiBond FL and Clearfil SE Bond) to dentin surfaces ground with different preparation methods.

METHODS

Extracted human molars were ground flat to expose mid-coronal occlusal dentin surface with one of six preparation methods--P120 grit SiC paper, P400 grit SiC paper, P1200 grit SiC paper, medium grit diamond bur, fine grit diamond bur, and carbide bur. Each of the adhesives was used to bond resin-based composite to the dentin surface. Dumbbell-shaped specimens were fabricated and microtensile bond strengths were determined. The subsequent debond pathway and micromorphological structures of representative dentin surfaces were examined under scanning electron microscopy. ANOVA and survival analyses were performed both assuming independence from and accommodating for within-tooth correlation between specimens.

RESULTS

By ignoring the correlations between specimens, statistical analyses revealed no surface preparation effect on microtensile bond strength for each adhesive system. However, effects of surface preparation method on dentin adhesion of both adhesives were detected when accommodating for any within-tooth specimen correlations. Overall, carbide bur group showed the lowest bond strength for both OptiBond FL and Clearfil SE Bond. Dentin surfaces ground with diamond burs tended to present more compact smear layer than those ground with SiC papers and, subsequently, produced an effect on resin-dentin bond strengths.

CONCLUSIONS

The dentin surface preparation method affects smear layer characteristics and dentin surface topography and, therefore affects resin-dentin bond strength. Smear layer denseness, more so than thickness, may compromise bonding efficacy of adhesives, especially of the self-etch systems.

Spark erosion as a metal–resin bonding system

PURPOSE

Resin to metal bond strength of two commercial and one experimental metal-resin bonding system for crown and bridge veneer composites was evaluated.

MATERIALS AND METHODS

All specimens were prepared and tested according to ISO 10477 Amendment 1. A high precious alloy (HPA), a Co/Cr-alloy (Co/Cr) and pure titanium (Ti) were wet-ground to a final surface finish of 800 grit and air-dried. Twenty specimens of each metal were treated with Rocatec (RO), 20 with a Silano-Pen (SP), and 20 with the experimental spark-erosion (SE) bonding system. A light-curing opaque and a crown and bridge veneer composite were applied to each metal specimen. Ten specimens of each metal and bonding system were stored in water for 24h at 37 degrees C, 10 were thermocycled (TC) 5000 times in a water-bath between +5 and +55 degrees C prior to measuring shear bond strength (SBS). Scanning electron microscopy (SEM) was used to examine the treated metal surfaces.

RESULTS

After 24h SE generated significantly higher SBS values on Ti than RO (p<0.05). SP revealed the highest SBS for Co/Cr. After TC significant decreases occurred for RO on HPA, for SP on Co/Cr and Ti, and for SP on Ti. SE revealed the highest mean bond values for all metals. These results and SEM proved that no sandblasting is required for SE to obtain good bond strength.

SIGNIFICANCE

The experimental spark-erosion bonding system is an easy and very effective method for surface-treating alloys to obtain high SBS values for crown and bridge veneer composites.

The bond strength of particulate-filler composite to differently oriented fiber-reinforced composite substrate

PURPOSE

The primary failure mode of fiber-reinforced composite (FRC) materials used intraorally is delamination or debonding of particulate filler composite (PFC), the esthetic veneer, from the underlying FRC framework. The objective of the current study was to evaluate the effect of unidirectional fiber orientation and load direction on the shear bond strength of PFC to FRC.

MATERIALS AND METHODS

Unidirectional E-glass FRC was used as an adhesion substrate for the PFC. E-glass FRCs were oriented in three ways--Group A: in the plane perpendicular to the bonding surface; Group B: along the bonding surface longitudinal to the load; and Group C: along the bonding surface, transverse to the load. The FRC substrates were ground flat with 1200 grit. The PFC adherend was bonded to FRC using an intermediate resin. Twelve specimens for each group were water stored (37 degrees C) for 3 days before a shear bond strength test was conducted.

RESULTS

A one-way analysis of variance showed that the direction of the applied load to the fiber direction had a significant effect on the bond strength values (p < 0.001). A Weibull analysis produced values (characteristic strength and Weibull modulus) of Group A (46.5 MPa, 12.1), Group B (40.6 MPa, 4.6), and Group C (27.6 MPa, 3.5).

SIGNIFICANCE

The highest shear bond strength values and Weibull modulus were obtained when the fibers were oriented perpendicular to the bonding surface, exposing the fiber ends to the PFC. Interface strategies between hybrid composite layers may be developed to exploit anisotropic behavior in the adherence between FRC and PFC.

Bonding of Resin Composite Luting Cements to Zirconium Oxide by Two Air-particle Abrasion Methods

The results of this in vitro study suggest that, in combination with air-particle abrasion methods, Panavia F and RelyX Unicem resin composite luting cements with phosphoric-acid methacrylate content provide a strong resin bond to zirconium oxide.

Evaluation of some properties of two fiber-reinforced composite materials

OBJECTIVE

Water sorption, flexural properties, bonding properties, and elemental composition of photopolymerizable resin-impregnated fiber-reinforced composite (FRC) materials (everStick C&B and BR-100) (FPD) were evaluated in this study.

MATERIAL AND METHODS

Bar-shaped specimens (2 x 2 x 25 mm) were prepared for water sorption and flexural strength testing. The specimens (n = 6) were polymerized either with a hand light-curing unit for 40 s or, additionally, in a light-curing oven for 20 min and stored in water for 30 days. Water sorption was measured during this time, followed by measurements of flexural strength and modulus. A shear bond strength test was performed to determine the bonding characteristics of polymerized FRC to composite resin luting cement (Panavia-F), (n = 15). The cement was bonded to the FRC substrate and the specimens were thermocycled 5000 times (5-55 degrees C) in water. SEM/EDS were analyzed to evaluate the elemental composition of the glass fibers and the fiber distribution in cross section.

RESULTS

ANOVA showed significant differences in water sorption according to brand (p < 0.05). Water sorption of everStick C&B was 1.86 wt% (hand-unit polymerized) and 1.94 wt% (oven polymerized), whereas BR-100 was 1.07 wt% and 1.17 wt%, respectively. The flexural strength of everStick C&B after 30 days' water storage was 559 MPa (hand-unit polymerized) and 796 MPa (oven-polymerized); for BR-100, the values were 547 MPa and 689 MPa, respectively. Mean shear bond strength of composite resin cement to the FRC varied between 20.1 and 23.7 MPa, showing no statistical difference between the materials. SEM/EDS analysis revealed that fibers of both FRC materials consist of the same oxides (SiO2, CaO, and Al2O3) in ratios. The distribution of fibers in the cross section of specimens was more evenly distributed in everStick C&B than in BR-100.

CONCLUSION

The results of this study suggest that there are some differences in the tested properties of the FRC materials.

The influence of surface treatment and luting cement on in vitro behavior of two-unit cantilever resin-bonded bridges

OBJECTIVES

The purpose of this study was to find the optimal combination of surface pretreatment and luting cement for two-unit CoCr cantilever resin-bonded bridges.

METHODS

Tensile peel, load and torque strength tests were performed using flat ground bovine teeth as substrate, four different commercially available luting cements, and CoCr beams as simulated cantilever resin-bonded bridges. The CoCr beams were pretreated with sandblasting or Rocatec. Tensile peel, load and torque strengths were determined 72h after cementation. The effects of sandblasting and Rocatec pretreatments on the morphology of the CoCr surface was investigated with SEM and EDAX analysis.

RESULTS

The average strengths of the three tests showed that Rely X ARC, Resiment and Panavia were the same and significantly lower than UniFix. Rocatec showed a significantly higher average bond strength than sandblasting considering all tests. The peel test, which showed the lowest failure values, is clinically the most relevant test. This test showed that only UniFix as luting cement with sandblasting as pretreatment generates a significantly higher bond strength compared with the other cements and pretreatments.

SIGNIFICANCE

Based on the results of this study the use of Unifix with sandblasting as metal surface pretreatment, is preferred for cementation of two-unit CoCr cantilever resin-bonded bridges.

In vitro retentive strength of zirconium oxide ceramic crowns using different luting agents

STATEMENT OF PROBLEM

In contrast to gold crowns, in vitro determination of the retentive strength of all-ceramic crowns is more difficult because components allowing connection to testing apparatus are not as easily integrated into the all-ceramic material. Nevertheless, retentive strength data are crucial for obtaining information about the potential clinical performance of luting cements for all-ceramic restorations. Therefore, a new in vitro model was necessary to evaluate the retentive strength of all-ceramic crowns.

PURPOSE

The purpose of this in vitro study was to determine the retentive strength of 4 resin-cement systems, a compomer, a glass-ionomer cement, a resin-modified glass-ionomer cement, and a self-adhesive resin for luting zirconium oxide ceramic crowns.

MATERIAL AND METHODS

One-hundred-twenty extracted human teeth were randomly divided into 12 groups (n = 10) and prepared in a standardized manner (5-degree taper, 3-mm occlusogingival height). All-ceramic crowns (Lava) were fabricated in a standardized manner for each tooth. The following cements and corresponding bonding regimens were used to lute the crowns to the teeth according to manufacturers' recommendations: CO, Compolute/EBS Multi; CO/RT, Compolute/EBS Multi/Rocatec; CB, Superbond C and B; CB/RT, Superbond C and B/Rocatec; CB/PL, Superbond C&B/Porcelain Liner M; PA, Panavia F; DC, Dyract Cem Plus/Xeno III; CH/PL, Chemiace II/Porcelain Liner M; RL, RelyX Luting, K/C, Ketac Cem/Ketac Conditioner; K, Ketac Cem; and RU, RelyX Unicem. After thermal cycling (5000 cycles, 5 degrees C-55 degrees C), the outer surfaces of the cemented zirconium oxide ceramic crowns were treated (Rocatec) to improve bonding and then placed into a low-shrinkage epoxy resin block (Paladur). The block/crown and tooth components for each specimen were connected to opposing ends of a universal testing machine so that crown retention could be measured. Crowns were removed from teeth along their path of insertion. The retentive surface area (mm 2 ) was determined individually for each tooth. Statistical analyses were performed using the Wilcoxon exact test, (alpha =.05) and a Bonferroni correction (alpha =.001).

RESULTS

The median (minimum/maximum) retentive strength values (MPa) were as follows: CO, 1.7 (0.6/4.3); CO/RT, 3.0 (1.3/5.4); CB, 4.8 (3.7/7.9); CB/RT, 8.1 (4.2/12.7); CB/PL, 5.3 (3.7/10.2); PA, 4.0 (3.3/5.1); DC, 3.3 (2.1/5.6); CH/PL, 4.0 (1.3/6.3); RL, 4.7 (2.8/6.6); K/C, 1.8 (0.6/2.3); K, 1.9 (0.2/4.5); and RU, 4.8 (2.5/6.7). Superbond C&B (+ Rocatec) specimens showed the highest median retentive strength, but were not significantly different from Superbond C&B without Rocatec pretreatment of the all-ceramic crown's inner surface. Compolute specimens also did not benefit significantly from the Rocatec pretreatment. Within the materials used without pretreatment of the ceramic, Superbond C&B, Panavia, Dyract Cem Plus, RelyX Luting, and RelyX Unicem showed the highest median retentive strength values and were not significantly different.

CONCLUSION

Within the conditions of this study, the compomer-cement, the resin-modified glass-ionomer cement, and the self-adhesive resin luting agent had the same level of retentive quality as the resin luting agents, Superbond C&B, and Panavia. Rocatec pretreatment of the ceramic surface did not improve the retentive strengths of Compolute and Superbond C&B.

Shear bond strength of Bis-GMA resin and methacrylated dendrimer resins on silanized titanium substrate

OBJECTIVES

The study compared the bond strengths of three resins, Bis-GMA and two novel experimental methacrylated polyester dendrimer resins to grit-blasted titanium substrate with three silanes.

METHODS

Two commercial dental silanes (ESPE Sil and Monobond-S) and an experimental 0.5 vol% 3-methacryloxypropyltrimethoxysilane were applied to grit-blasted Ti substrates. Light-polymerizable resins of Bis-GMA and methacrylated dendrimer were applied to the grit-blasted Ti substrate with polyethylene molds. The substrates with resin stubs (n = 10) were thermocycled (6000 cycles, 5-55 degrees C) or kept in water (37 degrees C, 24 h). The shear bond strength of the resin was measured at a crosshead speed of 1.0 mm min(-1). The surface examination, before and after silanization, was made with a scanning electron microscope (SEM). The silane reactions on the Ti surface were monitored by Fourier transform infrared spectrometry.

RESULTS

Statistical analysis (ANOVA) showed that the highest shear bond for thermocycled samples was obtained for Bis-GMA with Monobond-S (19.4 MPa, standard deviation (SD) 7.1 MPa), and after water storage with a laboratory-made silane (26.4 MPa, SD 8.1 MPa). The dendrimer and Bis-GMA resins conferred equal bonding properties to grit-blasted titanium after thermocycling. The silane, resin type, and storage conditions significantly affected the shear bond strength (p < 0.001 for all factors). SEM images suggested a mainly cohesive type of bonding failure.

SIGNIFICANCE

A dendrimer based resin and the Bis-GMA resin systems conferred statistically equivalent bonding properties to silica-coated Ti after thermocycling.